Effective Date: November 22, 2016
Responsibility: Superintendent of Program and Schools (Elementary/Secondary)
1.0 Rationale
In accordance with Ministry of Education PPM 81, school boards share, together with the Ministries of Education, Health and Community and Social Services, the responsibility for ensuring that no school-aged child should be denied access to education because of special health support needs during school hours. In order to fulfill this mandate, the Near North District School Board recognizes the importance of providing clear guidelines to Principals/Vice Principals and other Board personnel when a request is made for the provision of health support services.
2.0 Procedures
This guideline outlines the provision of health support services in the following areas:
- Physical Procedures
- Medical Procedures
See Appendix A for a listing of health support services in a school setting.
3.0 Personnel Delivering Services
The procedures outlined will be performed in the school by Board personnel or by community agency personnel as outlined below.
4.0 Physical Procedures
Physical procedures are health support services that have been requested by a pupil’s parent/guardian and prescribed by a physician or other health care professional and are to be performed by Board personnel during school hours.
4.1 Board personnel will perform the following physical procedures:
- lifting and positioning
- assistance with mobility
- feeding (not including G-tube feeding) (See Appendix B attached for further clarification)
- toileting (including only clean intermittent catheterization)
- general maintenance exercises and speech remediation, correction and rehabilitation programming in accordance with the Interministerial Guidelines for the Provision of Speech and Language Services released September 1988
- shallow surface suctioning (eg.oral or nasal suction).
4.2 The services of Ministry of Health personnel, usually through the Community Care Access Centres (CCAC) and occasionally from pediatricians, will be accessed/consulted as needed, in the training and direction of Board personnel in the performance of these health support services.
4.3 The Ministry of Health and/or community agency personnel shall remain responsible for the provision of intensive physio-occupational and speech therapy services.
4.4 When a parent/guardian requests health support services beyond the capacity, resources and/or requirements of the school and/or Board, the CCAC shall be notified and requested to intervene and provide the health support services in the school.
4.5 Students who are medically complex or have rare conditions – Due to the individual nature of students who are medically complex or have rare conditions requiring unique responses, other requests for interventions not covered in this procedure or any variations to the above procedures must be approved by the Superintendent in charge of Special Education.
5.0 Medical Procedures
Medical procedures are the responsibility of the pupil, parent/guardian or Ministry of Health (eg. CCAC personnel) or community agency personnel.
5.1 Board personnel will not perform any of the following medical procedures:
- manual expression of bladder/stoma
- postural drainage
- sterile intermittent catheterization
- deep suctioning (eg. throat and/or chest suction or drainage)
- administration of medication given subcutaneously or intravenously
- G-tube feeding (see Appendix B for further clarification)
- any invasive medical procedures
5.2 Administration of Medication – please refer to the Near North District School Board Administrative Guideline “Administration of Medication” for the procedure for the administration of oral medication by Board personnel.
6.0 Planning and Referral Process
6.1 Upon receipt of a request by a parent/guardian for the provision of health support services to a student, a plan shall be developed by the Principal/Vice-Principal and an Authorization for School Board Health Support Services (Appendix C) completed for the students requiring the health support services.
6.2 The Principal/Vice-principal or a school contact teacher assigned by the Principal shall oversee the plan and associated tasks for the provision of health support services requested by the parent/guardian, in consultation with the Ministry of Health and community agency personnel regarding the provision of appropriate/necessary training for Board personnel.
6.3 Referral to the appropriate CCAC should be made by the school Principal in situations where direct services provided by CCAC personnel or community agency personnel for medical procedures will be required.
6.4 Consultation with CCAC or the paediatrician/health care professional should also be made where training or consultation regarding the plan for an individual student is needed.
7.0 Training
7.1 Student specific training of Board personnel to provide health support services will be the responsibility of CCAC or other medical personnel including paediatricians as requested by the Board.
7.2 Documentation of training will be maintained (see Appendix C) by the school Principal and additional training will be arranged if there are changes in Board personnel or changes to the appropriate/necessary training.
7.3 A minimum of two Educational Assistants will be trained to perform each health support service and will document using the Procedure Log (Appendix D) each time a health support service is performed, as outlined below.
7.4 The use of the Procedure Log is required for the following:
- Catheterization
- Shallow surface suctioning.
7.5 The use of the Procedure Log is optional after consultation with a health care professional for the following:
- Lifting and positioning
- Assistance with mobility
- General maintenance exercises and speech remediation and correction programming
- Feeding
- Toileting
7.6 The Principal may determine the additional use of the Procedure Log.
7.7 Universal precautions will be encouraged and undertaken whenever possible in the performance of the health support services identified herein, including the vigilant use of regular hand washing with soap and water to prevent the spread of germs and infection.
7.8 It is acknowledged that the designation of roles and responsibilities for health support services in the school does not preclude, in emergency situations, the provision of health support services by designated Board personnel as per the policies and procedures of the Board.
